Inflammation a warning signal for cancer recurrence, death

10 Jun 2021

In colorectal cancer patients undergoing surgery, levels of specific inflammation markers prior to and after the procedure may predict recurrence and/or all-cause mortality, as reported in a study.

The study looked at two prospective cohorts of patients with stage I to III colorectal cancer. Data on inflammation markers—such as interleukin (IL)6, IL8, IL10, tumour necrosis factor-alpha (TNFα), high-sensitivity C-reactive protein (hsCRP), and a combined inflammatory z-score—were available for 747 patients before surgery and for 614 patients after surgery.

In multivariable Cox proportional hazard regression models, controlled for patient characteristics and clinical and lifestyle factors, higher preoperative and postoperative hsCRP levels were associated with elevated risks of recurrence (per doubling: hazard ratio [HR], 1.15, 95 percent confidence interval [CI], 1.02–1.30 and HR, 1.34, 95 percent CI, 1.16–1.55, respectively) and all-cause mortality (per doubling: HR, 1.13, 95 percent CI, 1.01–1.28 and HR, 1.15, 95 percent CI, 0.98–1.35, respectively).

Meanwhile, the risk of all-cause mortality but not recurrence seemed to increase with a doubling in IL8 levels (preoperative: HR, 1.23, 95 percent CI, 1.00–1.53; postoperative: HR, 1.61, 95 percent CI, 1.23–2.12) and with a higher combined inflammatory z-score (preoperative: HR, 1.39, 95 percent CI, 1.03–1.89; postoperative: HR, 1.56, 95 percent CI, 1.06–2.28).

Neither recurrence nor all-cause mortality was associated with IL6, IL10, and TNFα.

The findings underscore the complex role of inflammation in cancer recurrence and merit further clarification by looking into local inflammation at the tumour site.

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